MP35-03 INDICATIONS AND OUTCOMES OF SURGICAL TREATMENT FOR CHRONIC BACTERIAL PROSTATITIS IN A CONTEMPORARY CASE SERIES

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP35)1 Sep 2021MP35-03 INDICATIONS AND OUTCOMES OF SURGICAL TREATMENT FOR CHRONIC BACTERIAL PROSTATITIS IN A CONTEMPORARY CASE SERIES Johnathan Doolittle, and Daniel Shoskes Johnathan DoolittleJohnathan Doolittle More articles by this author , and Daniel ShoskesDaniel Shoskes More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002044.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Category II prostatitis or Chronic Bacterial Prostatitis (CBP) is characterized by recurrent bacterial urinary tract infections with a prostatic source. While antibiotics are the treatment of choice, infection may not be cured in at least 40% and surgery might be necessary. Indications for surgery and outcomes, vary widely in the literature. Our objective was to study our case series of surgery for CBP focused on indications and outcomes. METHODS: We retrospectively identified all patients undergoing surgical treatment for CBP managed by a single provider over the past decade. Pre-surgical variables included presence of recurrent infections, bacterial species, TRUS volume, presence of prostate stones, localizing prostatic cultures, and surgical treatment. Transurethral surgery was offered to patients with prostatic stones within the surgical capsule, and total prostatectomy to those with prostate cancer or nidus not manageable with TUR. Surgery therapy, outcome, complications and follow up were recorded. RESULTS: 19 patients with a mean age of 67.2 years underwent surgery from 2010 through 2019. Relevant pre and post-operative data for each of the 19 patients is reported in Table 1. All patients had documented recurrent infections despite antibiotics. Average TRUS volume was 45.6cc, stones were identified in 8/19 patients, and prostate cancer was diagnosed in 3 of the 5 patients that underwent pre-operative biopsy. 12 patients underwent TURP and 7 total prostatectomy (TP) with a cure rate for infections of 84.2% (16/19) and a mean follow up of 36.9 months. 4/19 patients experienced long term complications from treatment, including 3/7 patients after TP. One of 12 TURP patients developed a urethral stricture post operatively. CONCLUSIONS: Careful patient selection for surgical treatment of CBP with identifiable prostatic localization of a surgical target or concomitant cancer resulted in a 84.2% cure rate in our series with over 3 year follow up. While TURP is seldom effective as a cure all for “prostatitis”, careful patient selection can lead to a high bacteriologic cure rate. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e627-e627 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johnathan Doolittle More articles by this author Daniel Shoskes More articles by this author Expand All Advertisement Loading ...